Individual
MRS. YIAN JAN HUDDLESTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
10102 NE GLISAN ST, PORTLAND, OR 97220-4456
(503) 286-6868
Mailing address
1605 NE 138TH PL, PORTLAND, OR 97230-4012
(503) 888-6153
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H5519
OR
Other
Enumeration date
05/11/2018
Last updated
05/11/2018
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